Psychopathology Trajectories of Children with ASD: The Role of Family Poverty and Parenting

Midouhas, E., Yogaratnam, A., Flouri, E. & Charman, T.  (2013).  Psychopathology trajectories of children with autism spectrum disorder: the role of family poverty and parenting.  Journal of American Academy of Child and Adolescent Psychiatry.  52(10). pp. 1057-1065.


Autism Spectrum Disorder (ASD) is characterized by a combination of social impairment, difficulty in verbally communicating, and insistence on sameness (or routine).  This study suggests that kids with ASD tend to carry a high rate of co-occurring psychopathology, or a co-morbidity of another mental disorder at the same time.  While little is currently known about risk factors involved, this study shows us the effect of family poverty on psychopathologic trajectories in young kids with ASD, with ages ranging from 3 to 7 years old.

This longitudinal study sought to understand whether home organization, and maternal warmth and involvement played a significant role in the development of co-existing psychopathology.  It also sought to discover whether family poverty was associated with broad and specific (emotional and conduct problems), and whether household chaos was a risk factor for conduct problems and maternal involvement.

We do know that genetic risk factors play a role in the biological development of ASD, although environmental factors appear to present as well.  We also know that verbal cognitive ability is a strong predictor of emotional and behavioral adjustment, and is also related to family poverty.  This study aims to discover whether Family Socioeconomic Disadvantage (SED) is a risk factor for psychopathology.  The longitudinal study focused on children from the preschool age to the middle school age, and heavily focused on these three factors - maternal warmth and involvement, home organization, and SED - and whether there was a link connecting a lack of emotional involvement and lack of responsiveness in the parents, specifically the mother, and co-existing psychopathology in the child.

This study hypothesized that SED and household chaos contributes to heightened levels of psychopathology in children with ASD.  The study further hypothesized that greater parental warmth or involvement would be associated with less psychopathology, and that parental warmth, involvement, and home organization would help to moderate the effect of SED on children's co-existing psychopathology.  The study tested the role of parenting in mediating and moderating the effects of ASD.

The method of the study involved collecting data from the same children at ages 9 mos, 3 years, 5 years, and 7 years old.  At the final 3 data collections, or sweeps, parents were asked to fill out a report of Strengths and Difficulties Questionnaire (SDQ), which measures emotional symptoms, conduct problems, hyperactivity, inattention, and peer relationship problems.  Parenting style was assessed by using the Child-Parent Relationship Scale, which gauges how often parents engage their children in reading, learning ABCs, teaching how to count, songs, poems, rhymes, painting, and drawing.

The results of the study found that kids with ASD had significantly higher rates of broad and specific psychopathology than their neurotypical peers.  The main effect of SED was statistically significant only on emotional and conduct problems, and it was found that the mother's education level played a big role.  Kids with more problems at age 5 increased in their problems over time as a direct effect of low maternal warmth during the preschool years.  Maternal warmth fully explained the effect of poverty on broad psychopathology (emotional and conduct problems), and findings suggest that warmth may indeed play a significant role in the development of psychiatric symptoms in children with ASD, particularly those living near the federal poverty line (FPL).

Megan Bursch